Is early menopause increasing the risk of rheumatoid arthritis

It is a natural biological process and takes place usually at the age of 51-52 years. If it occurs before the age of 45, then it is known as early menopause and, if before 40, then as premature ovarian failure. Early menopause brings a sudden fall in the two significant female hormones called estrogen and progesterone much earlier than the anticipated level in the body.

Modulation of the immune system is another critical effect of estrogen. The premature loss of estrogen results in the disturbance of immune responses and increases susceptibility to autoimmune diseases such as rheumatoid arthritis. It has been observed that there is a connection between early menopause and seronegative RA, a milder form of the disease. Cellular mechanisms change due to hormonal imbalance in early menopause, which may activate autoimmune reactions and inflammatory processes. In addition, the process of menopause changes communication between the brain and ovaries, and in the case of premature ovarian failure, this happens much earlier.

Interestingly, there's a bidirectional relationship between these two conditions where women with early menopause may contribute to autoimmune diseases such as RA. Often, women who develop early menopause report symptoms which include pain in the joints and generalized muscle fatigability and body aches, which can mimic RA, thus posing diagnosis and management challenges.

Medical doctors highly advise MHT because of the risks of premature menopause. MHT is an existence use, which was termed HRT. Scientific literature and studies show MHT's keeping of a balance of hormones which reduces the possibilities of developing RA and other complications caused by deficiency of estrogen in women who undergo early menopause when they are before reaching the age of natural menopause that falls within 51 to 52 years.




Published in the British Medical Journal in January 2024 by the British Menopause Society, a relevant study points that women who reached menarche after 14 years and developed menopause below 45 are at increased risks of developing rheumatoid arthritis. This report emphasizes the watchful observation concerning hormonal health to consider MHT for at risk women.

Medical consultation is required in the acquisition of individual risks and benefits before the implementation of MHT. Follow-ups are also made from time to time in the optimal management of hormonal health. This will help women deal with early menopause before it can lead to risks, improve the quality of life, and prevent autoimmune diseases such as rheumatoid arthritis.

(Dr Nidhi Sharma Chauhan, consultant obstetrician and gynaecologist, Saifee Hospital, Mumbai)